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Peritoneal Carcinomatosis: Role of 18F-FDG PET

Alla Turlakow, MD, Henry W. Yeung, MD, Aida Sanchez Salmon, MD, Homer A. Macapinlac, MD and Steven M. Larson, MD

Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York



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  		FIGURE 1. An 80-y-old woman with stage IIIC ovarian carcinoma after 6 cycles of neoadjuvant chemotherapy. Preoperative 18F-FDG PET scan shows focal pattern of peritoneal carcinomatosis. (A) Coronal section demonstrates hypermetabolic foci distributed randomly throughout abdomen and pelvis, unrelated to solid viscera or nodal stations. (B) Sagittal section demonstrates their typical anterior location. After debulking procedure, including total abdominal hysterectomy and bilateral salpingo-oophorectomy and partial omentectomy, peritoneal implants progressed on subsequent PET scans.

 


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  		FIGURE 2. A 47-y-old woman with poorly differentiated adenocarcinoma of stomach (linitis plastica type), 6 mo after sub-total gastrectomy, with persistent nausea and vomiting, referred for exclusion of disease recurrence. 18F-FDG PET scan, coronal section, demonstrates metabolic pattern characteristic of diffuse peritoneal carcinomatosis with uniform low-grade 18F-FDG uptake throughout entire abdomen and pelvis obscuring normal, discrete, visceral outlines, particularly bowel, liver, and spleen. Her demise was precipitated by gastric outlet obstruction and progressive cachexia.

 




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